Newpharmablog. Health News

In the past it was often claimed that endometriosis could be prevented if women had frequent pregnancies early in their reproductive life. But it is now well documented that early and frequent childbearing does not necessarily protect a woman from developing endometriosis as many women have been diagnosed after they have had their children.

So far, gynaecologists and researchers have not been able to find a way of preventing endometriosis because no one knows precisely the causes or what factors influence its development or who it affects.

There is a considerable amount of research being carried out which is attempting to identify the possible factors that may increase or decrease a woman’s risk of developing endometriosis. To-date, none of the results have been sufficiently consistent for any conclusions to be made. In the future it may be possible to identify those women and girls who are most likely to develop endometriosis and to offer them advice regarding the things that they could do to reduce their risk of developing the condition.

Eventually, when more is known about what determines how — and why — the misplaced endometrium implants in some women and not others, it may also be possible to find ways to prevent endometriosis from occurring altogether or at least to prevent recurrences of the condition. For example, it may be possible to develop a vaccine against the condition or to develop drugs which cure the condition permanently.

Lyn’s story

It came as something of a shock when I was told in December 1986 that I had endometriosis — a shock because I had never heard of ‘endometriosis’.

Coming from a family of eight children I suppose I just assumed fertility would never be a problem.

Thinking back now, I am sure I developed endometriosis when I was about 16 — about two years after I started menstruating. I would get severe cramps on the first two days of my period, usually requiring me to stay home from school tucked up in bed with my faithful hot water bottle.

I remember waking one night in such severe pain I could hardly walk. I staggered to the bathroom, thinking I had a severe bout of diarrhoea. For two hours I suffered hot flushes and pain which, although I have never experienced childbirth, came with the irregularity of labour pains. I remember staggering out of the bathroom and fainting — much to the horror of my father.

You see, he was a jockey and his small five foot frame was no match for my larger, heavier and limp body. Much to his credit, he was able to carry me to bed!

The next morning my mother took me to our local doctor. After describing the symptoms, he told us I had probably experienced a twisted bowel which had ‘corrected itself. His solution for my painful periods was to put me on the pill.

For the next 10 years I went on and off the pill. I didn’t think it was too healthy to stay on the pill for such a long stretch but each time I took a break, the cramping periods would be back as bad as ever. It was easier to stay on the pill and enjoy a relatively painless cycle.

In 1985 my husband and I decided it was time to start a family. I just presumed that the first month off the pill would result in the expected pregnancy.

When this didn’t eventuate, I was given the usual advice: ‘Try not to think about it dear’, ‘Your job is too stressful’, ‘Just relax!’.

Six months later I had another attack of what I thought was a twisted bowel. Again I went to a doctor and again he confirmed that it was a twisted bowel which had corrected itself. I mentioned to him that I was having difficulty becoming pregnant. His answer was that as I was only 25, 1 shouldn’t worry. He said he would not recommend seeing a specialist for another two years.

Neither my husband nor I were happy with that suggestion and we decided to see another doctor. As luck would have it, a girl I went to school with was working as a GP near our home. I went to her, told her my symptoms and had an appointment with a gynaecologist two weeks later. That’s when the fun really started. On my first visit, he did an internal examination and told me I was very tender on my right side. Who wouldn’t be tender when someone is tugging at your ovaries!

He suspected an ectopic pregnancy and sent me to have blood tests and an ultra-sound, both of which confirmed I was not pregnant. I was then booked in to have a laparoscopy and this revealed I had severe endometriosis.

*15/41/5*

The first thing to do when trying to combat stress is to read the preceding parts of this section of the book. Start by improving what you eat, by taking more exercise, by breathing better, by getting more and better-quality sleep and by changing your lifestyle and attitudes. Even if you do nothing else and your life continues to have just as many potentially stressful events as before you’ll feel a new person and many of the above list of symptoms will disappear over a few weeks.

There are other steps, though, that you may find helpful. They include activities with proven value in reducing stress both at the stressful time itself and in between.

There are so many types of relaxation exercises that a book such as this cannot even give an overview of them. Here, however, is one example of an exercise sequence that is simple and effective:

• Take the phone off the hook

• Make sure the room is warm and quiet and that you won’t be interrupted

• Choose a time of day that is free from stress (morning or evening is best)

• Avoid doing the exercises after a meal

• Try to do them twice a day

• Put a blanket on the floor or sit directly on the carpet

• Wear loose clothing-nothing constricting

• Remove shoes, ties; undo bra or belt

• Sit up in a supported position

• Clear your mind of intrusive thoughts and let things happen

• Breathe deeply and regularly

• Once the breathing is established try to introduce thoughts such as of a wave of warmth or

happiness coming over you. All this relaxes tense muscles and the action of the sympathetic

nervous system and prepares you for the relaxation exercises you want to do. For example:

• Systematically and consciously relax all the areas of the body in sequence

• Start with the feet-deliberately tighten the foot muscles and then relax them after 10 seconds

of holding them in tension. Feel them release as you let go. Try consciously to register how

good this feels

• Work up to the top of the body, tightening and relaxing area by area

• Do this for ten minutes and then spend a further ten minutes returning to normal. Just sit or

lie there feeling relaxed and carry on with the deep breathing. Get up slowly and gently to

resume your normal activities.

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“We need you in San Francisco in 48 hours,’” shouts Rosanna Pit-tella, mimicking her job’s frequent and urgent demands for air travel. “Usually, I’d go by the seat of my pants and come home with 10 extra pounds.”

She’s exaggerating, of course, but not by much. At one time, the 41-year-old consulting-firm director and mother of three carried 263 pounds on her 5-foot-2-inch frame. She blames the excess baggage on the sheer exhaustion of making repeated crosscountry trips. “When you’re that tired, you eat what’s convenient—and that often means unhealthy foods,” she says. “And once I’d blow it, I’d feel sick the whole trip. It sets up a cycle of bad eating.”

Finally, Rosanna wised up to her unhealthy ways. Temptation is greatest when you’re out of your routine,” she says. So she devised a plan for ensuring that she sticks with her healthy eating habits when she travels. “I pack an emergency food kit, using an insulated lunch bag that belonged to one of my kids,” she explains. “I fill it with cans of tuna, small cans of vegetables, canned snack packs of fruit that are for kids’ lunches (the portion sizes are perfect), fresh fruit, and bottled water. That way, I’m not a victim of airport food or late-night room service because it’s the only thing available.”

Today, a year later and 103 pounds lighter, Rosanna is happy, comfortable, and soaring with energy. She says that packing her emergency food kit is like brushing her teeth. “I won’t leave the house without doing either one,” she says. “They’re so much a part of me that I can’t avoid them.”

WINNING ACTION

Flying? Don’t forget your food. You don’t have to be a frequent flier like Rosanna to face the nutritional pitfalls of air travel. Your best bet is to prepare for your hunger.

Pack your carry-on bag with healthful snacks such as bagels, fresh or dried fruit, single-serving boxes of cereal, and nonfat or low-fat sliced cheese. Take some water, too. Airplane cabins are extremely dehydrating; during a 3-hour flight, you can lose more than a pint of water through your skin and by breathing.

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The pain can sometimes be helped by the wise use of antidepressant medication, which causes an increase in the body’s natural production of pain-killers — the endorphins.

The most common form of treatment is a combination of physical therapies and non-steroidal anti-inflammatory drugs such as Dolobrid, Indocid, Brufen, Naprosyn, Voltaren, Orudis, Clinoril and Feldene. Aspirin and Paracetamol are also useful as pain killers and as drugs controlling inflammation. Specially coated or slow-release forms of aspirin have been developed to reduce the gastric problems associated with long term aspirin usage. These include Ecotrin, a specially coated tablet which releases its aspirin into the small intestine and not the more sensitive and fragile stomach lining.

Other drugs used in the treatment of arthritis include the cor-tico-steroid or steroid drugs such as Prednisolone and Depo-Medrol. These can be taken by mouth or injected directly into the joints.

Physiotherapy has a major place in the treatment of pain associated with arthritic conditions. Gentle mobilisation of affected joints together with the application of heat and cold to the joints will help keep those with advanced arthritis mobile.

Water-based exercise in the form of hydrotherapy and the more vigorous aqua-aerobics takes the strain of gravity from the painful and stiffened joints.

In the later stages, when joints are burnt out, surgical procedures are carried out to help those with artificial joints or to fuse joints which are too painful to move.

*70\37\8*

What is a ‘pain game’? It is often an expensive and emotionally exhausting experience for the patient and family and a long-standing disappointment for the medical profession. The term ‘game’ to doctors specialising in pain relief refers to the patient’s ways of behaving and reacting, as well as the family — and even the doctor. All have developed in reaction to the pain itself. When patients allow their suffering to control their behaviour, they are playing a ‘game’. There is thus little chance of relief. And there are no winners. Pain is more than just a hurt. Strangely, for many, it is a way of life. It may begin as a short game but sometimes it takes over and patients can find themselves trapped in the role they have unwittingly created for themselves. The symptoms can become a habit and this can then slide into a lifestyle. From the patient’s point of view, the therapy and treatment have usually been ineffective, sometimes destructive and often very costly.

Some build their lifestyle around their pain. They actually enjoy their poor health. While every day and night is an ordeal ranging from discomfort to downright agony, they at the same time find it as comfortable as putting on an old pair of slippers. Their pain has the comforting ring of normality. Relieving the pain actually disrupts their attitude-behaviour system. At the very least, pain behaviour is a mindless bad habit. It can be broken, but, it can also become an addiction.

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Pain is also common in patients suffering from depression. Psychological testing shows depression in up to 80 percent of chronic pain patients. Patients should be aware that they may be suffering from masked depression. Treatment of the depression frequently greatly reduces pain. In turn, a decrease in pain may also cause a decrease in depression.

Recent research confirms that dietary manipulation may be possible. Certain natural substances appear to be the forerunners of brain chemicals important in pain control. For example, the amino acid L-Tryptophan is a substance that is converted to Serotonin (also called 5HT), a brain transmitter substance involved in pain perception. When taken orally, it may help to modify the experience of pain and to encourage natural sleep. Some caution in the administration of L-Tryptophan may be necessary.

At the time this book was written disturbing reports of abnormally increased number of eosinophils (white blood cells) due to L-Tryptophan have been received in the United States and in Europe. This has led to the withdrawal of L-Tryptophan containing preparations in America and Australia. Another amino acid, D-L Phenylalanine, blocks the destruction of the natural opiates — endorphins — produced by the brain.

*25\37\8*

Chronic pain is that which is persistent or recurrent and lasts longer than the usual expected time after illness or injury. Low back pain is by far the most common form of chronic pain, comprising about

80 per cent of cases. Millions more suffer other chronic pain conditions such as the excruciating facial pain of trigeminal neuralgia,TMJ (temporo-mandibular joint dysfunction syndrome) affecting the jaw joint, post-herpetic neuralgia and phantom limb pain. Many cope with headaches, arthritis and other musculo-skeletal problems without excessive invalidism, medication, or health care. Unfortunately, a significant number of chronic pain sufferers have a complex variety of feelings, thinking and behaviourial symptoms.The financial costs of chronic pain may well be the highest of any health problem.

It includes the costs of social security payments, treatment, workers compensation and the loss of productivity. In New South Wales, 1984-85 figures showed that ’sprains and strains’ accounted for 49.5% of claims for workers compensation, a total of 48,751 cases. The NSW compensation payout had risen from $286 million in 1980 to $666 in 1984-85. Australian Bureau of Statistics (ABS) figures quoted in a leading article on pain in The Bulletin magazine showed that over 20% of compensation claims in Australia were for the condition of Repetitive Strain Injury (RSI) consisting of work related synovitis, bursitis and myofascial pain disorders. A further 20% had other problems of the musculoskeletal system and connective tissues. Apart from industrial deafness at 42% of claims, no other condition exceeded more than 4% of the total.

The ABS survey showed that headache due to unspecified or trivial causes was the most common Australian complaint. Some 10% said they had suffered one in the two week survey period. According to the Arthritis Foundation of Australia, one person in 12 in this country suffers from arthritis. This means that 1.3 million Australians have pain as a major disability. Arthritis accounts for more lost work days (over 7.5 million man hours) than any other medical condition and exceeds those lost due to industrial strikes.

The social costs of chronic pain are even more tragic, with so many young sufferers incapacitated for life, and the subsequent disruption to the family, the individual and society as a whole. Rather than brand sufferers as ‘neurotic and hysterical’, a more enlightened approach is called for, with early treatment, research and ultimately prevention.

Chronic pain in Australia is also a major issue in law suits and disability-benefit decisions. Whether or not a pain sufferer is typical of a hospital’pain clinic, or of a private practice population, the behaviour of pain patients gradually becomes less consistent with organic pathology.

*3\37\8*

Hay-fever sufferers may feel sorry for themselves as the summer months approach, but they are envied by those afflicted with perennial rhinitis, who have to endure similar symptoms all year round. In their case it is usually airborne allergens, such as mould spores or house dust, which trigger mast cells in the nose. If the eyes are also affected this will cause conjunctivitis. It is almost always airborne allergens that affect the eyes, but the nose is also susceptible to allergens from other sources, including food. For the full range of allergens that can provoke rhinitis.

Problems caused by rhinitis

The nose is intimately linked to several other organs and problems here are likely to have effects elsewhere. Because the nose is connected to the middle part of the ear by a tube (the Eustachian tube), perennial rhinitis can affect the ears as well. The Eustachian tube’s function is to drain any fluid from the ear and allow air to get into the ear so that the pressure on either side of the eardrum is equalized. If the tube becomes blocked with mucus from the nose, air can no longer reach the middle ear and the air already there becomes replaced by a thick, sticky secretion produced by the ear itself. This mucus sticks to the delicate bones that play a vital role in our hearing, and thus causes deafness. The condition is known as chronic secretory otitis media (CSOM) or glue ear, and although it may be caused in other ways this is undoubtedly an important one. The problem is particularly common in children.

Children suffering from this problem are likely to complain of popping or itching in the ears, or say that their ears feel ‘blocked up’. The first signs of deafness are sometimes mistaken for disobedience because they fail to do as they are told. In younger children there may be little outward sign of the problem, although some shake their head in a characteristic way or repeatedly scratch at their ears. Deafness may result in the child being slow to begin speaking – often the first indication that anything is wrong. Needless to say, there are a great many other reasons for delayed speech, and it would be a mistake to jump to conclusions on this basis alone.

*48\180\8*

Inflammation of the nerves (neuritis) may also be treated successfully with Symphosan. In fact, wherever there are painful parts in the body, or wherever there is any sensitivity to pressure which manifests itself in the peripheral nerves, Symphosan can be recommended as a simple, natural and efficacious remedy.

It is extraordinary what a regenerating influence Symphosan has on the skin. Wrinkles, crow’s feet and other signs of premature aging will be regenerated by its continuous use. As far as age allows, it is possible to have a firm, youthfully fresh skin. Symphosan is therefore a valuable cosmetic and should not be missing

from the dressing table. It does more than improve the appearance, it promotes good health, and true beauty is identified with health. If Symphosan is used for cosmetic purposes, it should be alternated with a good skin oil.

Abrasions, cuts and injuries which take a long time to heal will respond favourably to Symphosan and heal more quickly. It relieves pain and is anti-inflammatory, and also helpful for haema-tomas, that is, blood blisters and swellings filled with effused blood.

*708/28/1*

After some great physical strain or effort, particularly at the end of a day of heavy housework or gardening, people often complain about their aching back. Yet the cause of the pain is not necessarily connected with general tiredness caused by the work. Many other causes can be responsible for backache and if it keeps returning it is advisable to look for the true source of the problem.

If the pain is relatively high up, causing a feeling of contraction, the person may actually be suffering from kidney trouble. Should the pain be felt a little lower down it may be the symptom of prostate (in the case of men) or bladder trouble. Backache can also stem from a degeneration of the bones, for example in a case of ‘arthritis deformans’. A change in the position of the uterus can also trigger backache, and even muscular rheumatism may be interpreted as backache, as can sciatica when it starts higher up.

Backache being a nuisance, the sufferer seeks to get rid of it quickly. For this purpose use a good warming ointment. Apply Sympbosan for a change. It is also beneficial to place some moist, hot hay flowers or camomile, tied in a cloth, on the painful area. Should this treatment not alleviate the pain and improve the condition, it is advisable to consult a doctor in order to identify the real cause of the pain, which can then be treated accordingly.

*664/28/1*